Cancer patients and advocacy groups have raised alarms over the Social Health Authority (SHA), saying the new system is creating unnecessary obstacles that intensify both emotional and financial burdens.
On Tuesday, they told the National Assembly that delays, unclear processes, and rigid payment requirements are making it harder for patients to access essential care.
At a session with the National Assembly’s Departmental Committee on Health, officials from the Kenya Network of Cancer Organizations (KENCO) described the SHA system as chaotic, leaving thousands of patients stranded even when they are fully registered and have paid their dues.
KENCO Executive Director Phoebe Ongadi explained that the transition from the old National Health Insurance Fund (NHIF) to SHA has created additional barriers for those seeking chemotherapy, radiotherapy, and follow-up consultations.
“SHA has increased emotional distress more than the disease itself,” Ongadi told MPs. “Patients live in constant fear—wondering when their treatment will be approved, when their financial year begins, or when they’ll be told to pay out of pocket.”
She highlighted the example of Mary Nafula, a registered member whose account was suddenly declared expired in the middle of treatment, despite paying her annual contributions twice within three months.
“This confusion is breaking patients both emotionally and financially,” said KENCO Vice Chairperson Prisca Githuka. “The very system designed to protect patients is instead failing them.”
The group also criticized SHA service points in hospitals for lacking trained personnel and clear information, forcing patients to travel to Nairobi to resolve issues.
“Patients are simply told their accounts have expired, with no explanation,” Githuka said. “These offices need to be empowered to handle patients efficiently.”
KENCO recommended that the government introduce flexible payment options, noting that the current annual lump-sum approach is unrealistic for many patients, especially those in informal employment.
“We are not refusing to pay,” Githuka emphasized. “But paying the full annual fee at once is too heavy. A monthly or quarterly system would be more realistic.”
Peter Kinyanjui, a cancer survivor and matatu operator, agreed, saying monthly payments would be manageable for informal workers, similar to the NHIF model.
“My colleagues are ready to pay, but the annual one-off payment is too high,” he said. “Monthly contributions would allow more people to participate and maintain the scheme.”
The organization also raised concerns about the Primary Health Care Fund and the Emergency, Chronic, and Critical Illness Fund (ECCIF), which remain underfunded, limiting early diagnosis and timely access to treatment.
“These funds exist on paper, but in reality, they are empty,” Ongadi said. “Patients are moved to new coverage tiers once limits are reached, but no funds are available. This undermines the promise of Universal Health Coverage.”
KENCO shared that Kenya records roughly 44,700 new cancer cases each year, with over 29,000 deaths. Breast, cervical, prostate, oesophageal, and colorectal cancers are the most common, with 70 percent diagnosed at late stages.
“We rely on global statistics, which may still underestimate the true situation,” KENCO said. “A stronger National Cancer Registry is critical to inform policies accurately.”
Committee Chair James Nyikal (Seme MP) praised KENCO for presenting data-backed findings, noting the issues match what the committee has observed nationwide.
“What you have presented aligns with our own findings across the country,” Nyikal said. “We will include your recommendations in our report and follow up with the Ministry of Health and county governments.”
He said the main problems stem from gaps in information flow and fund management at hospitals.
“Both patients and service providers lack clear guidance,” Nyikal said. “We will coordinate with the ministry and counties to address these systemic weaknesses.”
KENCO also proposed including cancer survivors and patients in decision-making bodies such as the Benefits Package Tariff Advisory Panel to ensure policies reflect real-life patient experiences.
“We live these policies every day,” Githuka said. “Including patients would make reforms more practical and effective.”
Nyikal welcomed the suggestion, adding it will be forwarded to the Health Ministry for consideration, though legislative changes may only take effect after Parliament resumes next year.
